Effective Treatment of Cartilage Abnormalities in Middle-Aged Individuals (Aged 45-60): Bounding Molecular Biology with Microfracture and Hyalofast Membrane Approach Show Positive Outcomes.

Abstract

Background/aims: In recent years, significant progress has been made in treating cartilage lesions, leading to various techniques aimed at articular surface regeneration. However, the impact of patient age on treatment outcomes remains understudied, despite its recognized influence on effectiveness. Many studies impose upper age limits, resulting in limited data on middle-aged patients, a group frequently undergoing cartilage repair. Age-related physiological changes, including a decline in regenerative capacity and alterations in proteoglycan composition, are believed to affect treatment success. This study investigates the clinical outcomes of cartilage repair in patients aged 45 to 60, specifically evaluating the effectiveness of microfracture combined with Hyalofast membrane implantation.

Methods: Patients aged 45-60 undergoing microfracture with Hyalofast membrane implantation were evaluated. Short- and medium-term outcomes were assessed using the KOOS and SF-36 questionnaires preoperatively and at 6- and 12-month follow-ups. Functional evaluations and MRI analyses were conducted by expert reviewers. Additionally, an intensive rehabilitation program was initiated immediately post-surgery. Statistical analysis was performed using a one-way repeated-measures ANOVA to compare preoperative, 6-month, and 12-month results, with Tukey's post-hoc test applied for multiple comparisons. Clinical significance was assessed using Cohen's d effect size, with standard thresholds for small, medium, and large effects.

Results: The combined microfracture and Hyalofast membrane approach, along with early rehabilitation, yielded promising results. Key benefits included reduced inflammation, improved membrane integration, and decreased subchondral edema.

Conclusion: These findings support the feasibility of this treatment strategy, highlighting its potential to enhance joint function, alleviate pain, and improve the overall quality of life in middle-aged patients.